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General NPI Number Information
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NPI Number | 1891170726
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Entity Type | Organization
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Legal Business Name | PELHAM BAY MEDICAL CARE FOR WOMEN PC
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Dates
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Enumeration Date | 07/21/2015
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Last Update Date | 07/21/2015
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Provider Practice Location Address
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Address Line | 3250 WESTCHESTER AVE SUITE 112
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City | BRONX
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State | NY
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Zip | 10461-4500
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Country | US
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Telephone | 718-231-7900
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Fax | 718-684-5298
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Provider Business Mailing Address
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Address Line | 3250 WESTCHESTER AVE SUITE 112
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City | BRONX
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State | NY
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Zip | 10461-4500
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Country | US
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Telephone | 718-231-7900
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Fax | 718-684-5298
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Authorized Official
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Title or Position | CEO
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Name | JENNIFER ANNE LAFONTANT
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Credential | MD
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Telephone | 718-231-7900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number |
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License Number State |
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